Sudden Cardiac Death Follow-up

Updated: Apr 28, 2014
  • Author: Ali A Sovari, MD, FACP, FACC; Chief Editor: Jeffrey N Rottman, MD  more...
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Follow-up

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Patients should be at centers where intensive cardiac monitoring and appropriate invasive and noninvasive studies can be performed. In general, a cardiovascular service, including interventional cardiology, electrophysiology, and cardiac surgery, is needed.

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Prognosis

Prognosis of morbidity and mortality for people who have had SCA can be made using the cardiac arrest score developed by McCullough and Thompson (see Physical). The detection of the underlying cause of SCD and available treatment options play an important role in the natural history and prognosis of SCD.

SCD/SCA is a frequently encountered problem for emergency physicians, internists, and cardiologists. Ischemic cardiomyopathy in all adult cases and HCM in pediatric and adolescent cases are at the top of the list of causes of SCA.

The clinical course, once the patient is resuscitated, largely is predicted by the ED presentation of hemodynamic stability, early neurologic recovery, and the duration of the resuscitation.

Patients who survive the initial phases require a systematic evaluation of LV performance, myocardial perfusion, and electrophysiologic instability. Survivors of SCA have a recurrence rate on the order of 20-25% per year, making ICD implantation important in the majority of these patients.

ICD implantation saves lives. Risk stratification will continue to be an area of active research.

Preventive measures, at their roots, are measures of coronary artery disease prevention. Efforts to inform and train the public about external defibrillator use likely will have a great public health impact on improving survival rates of SCA. However, more basic and clinical research is required to understand the mechanism of VF/VT and to be able to identify the patients at risk who benefit from ICD therapy.

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Patient Education

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